Paralisia cerebral: análise dos padrões da deglutição antes e após intervenção fonoaudiológica / Cerebral palsy: analysis of swallowing patterns before and after speech therapy intervention

OBJETIVO: analisar os padrões da deglutição antes e após intervenção fonoaudiológica em um grupo de crianças com Paralisia Cerebral que apresentam quadro de Disfagia. MÉTODO: estudo longitudinal, constituído por vinte crianças portadoras de Paralisia Cerebral, com idades entre um e oito anos, de ambos os sexos. Foi utilizada anamnese com os responsáveis e os pacientes foram submetidos à avaliação funcional da deglutição antes e após intervenção fonoaudiológica num período de três meses. RESULTADOS: percebeu-se discreta melhora no padrão de deglutição o que consequentemente trouxe um melhor padrão de alimentação aos pacientes avaliados e orientados. CONCLUSÃO: o presente estudo mostrou que a intervenção fonoaudiológica aos pacientes portadores de Paralisia Cerebral traz como resultado melhorias em seu padrão de alimentação, apesar do curto período de atendimento (três meses).

PURPOSE: to analyze swallowing patterns before and after speech therapy intervention in a group of children with Cerebral Palsy who have dysphagia. METHOD: cross-sectional study, consisting of twenty children with Cerebral Palsy, aged between one and eight years, both genders. We used a clinical history with the family heads and the patients were subjected to functional swallowing assessment before and after speech intervention in a period of three months. RESULTS: slight improvement was noted in the swallowing pattern which consequently brought a better pattern of meals to the patients. CONCLUSION: this study found that the speech intervention in patients with Cerebral Palsy brings as a result an improvement in their usual diet, despite the short treatment period(three months).

Síndrome da apneia e hipoapneia obstrutiva do sono e o enfoque fonoaudiológico: revisão de literatura / Sleep obstructive apnea-hypoapnea syndrome and the phonoaudiological focus: literature review

TEMA: Síndrome da Apneia e Hipoapneia Obstrutiva do Sono (SAHOS) é considerada um transtorno respiratório do sono, que afeta a população geral, com sintomas noturnos e diurnos que causam grande impacto na qualidade de vida do portador da síndrome. O interesse por tal patologia intensificou a partir do final dos anos de 1970 e recentemente vislumbra-se a fonoterapia como uma das alternativas para o tratamento da SAHOS. OBJETIVO: analisar as principais causas da síndrome da apneia e hipoapneia obstrutiva do sono e correlacioná-las ao trabalho fonoaudiológico. CONCLUSÃO: as causas mais encontradas relacionadas ao quadro da síndrome da apneia e hipoapneia obstrutiva do sono foram: redução da tonicidade do músculo genioglosso, comprimento excessivo de palato mole e úvula, obesidade, retrognatia e a prevalência em indivíduos do sexo masculino. O tratamento fonoaudiológico direcionado a estes indivíduos, seja ela em qual grau apresentar-se, proporciona uma melhora significativa do quadro, uma vez que o foco é a adequação da tonicidade e a mobilidade da musculatura orofacial.

BACKGROUND: Sleep Obstructive Apnea-hypoapnea Syndromeis is considered a breath sleeping disorder that affects people in general, with its night and day symptoms which causes a great impact on life quality of the syndrome carrier. The concern on such pathology increased at the end of the 70's and nowadays spech therapy is seen as one of the possible treatments for SOAHS. PURPOSE: to analyze the main causes of sleep obstructive apnea-hypoapnea and to correlate them with the phonoaudiological work, since that this acts on the phonoarticulate organs, mainly rehabilitating the soft parts of the oropharynx musculature. CONCLUSION: the most recurrent causes related to sleep obstructive apnea-hypoapnea syndrome are: tonicity reduction of genioglossus muscle, too long soft palate and uvula, obesity, retruded, drug addiction and major prevalence in male sex are the most frequent causes related to Sleep Obstructive Sleep Apnea-Hypoapnea. The phonoaudiological treatment given to the patients, no matter what is the level of their problem, makes them feel better since that the focus is tonicity adequacy and orofacial musculature mobility.

[Clinical and radiological study of swallowing in patients with deglutition disorders, classified into two age groups: adults and older people]. / Avaliação clínica e videofluoroscópica de pacientes com distúrbios da deglutição--estudo comparativo em dois grupos etários: adultos e idosos.

BACKGROUND: The abnormalities of swallowing process have multifactor and complex etiologies. The videofluoroscopy has been pointed as the exam of greater utility in diagnostic investigation for these cases. This method, when preceded of an adequate anamnesis, can characterize conveniently the level of the dysfunction and usually identify the cause of abnormality with great precision. AIMS: To study the clinical complaints and findings of the videofluoroscopy examination in patients with deglutition disorders and no clinical evidence associated with neurological disorder, classified into two age groups: adults and older people, and to analyze: symptomatic manifestations, kinds of disorders (oropharyngeal or esophageal) and the capacity of clarifying the clinical complaints through the method of images. MATERIALS AND METHODS: Seventy patients with complaint of the capacity of deglutition were analyzed. They had no clinical evidence of associated neurological syndromes or disorders and were classified into two age groups: adults (GI)-- < or = 65 years (n = 36) and older (GII) > 65 years (n = 34). All patients were submitted to anamnesis to obtain the information about their complaints concerning deglutition. The complaints were characterized as high or low, according to their predominant location of manifestation. All the patients were submitted to videofluoroscopy of the deglutition; these alterations were characterized as oropharyngeal or esophageal. The capacity of clarifying the clinical complaints by videofluoroscopy was evaluated in both groups. RESULTS: Among the complaints analyzed, the only one in which the statistical analysis presented a significant difference between the groups was the complaint of heartburn, which occurred more often in the group GI-- eight patients (22.2%) and GII--one patient (2.9%). In the study of videofluoroscopy, it was observed a higher incidence in the oropharyngeal disorder in group GII--41.2% while in group GI--13.9%. As for the esophageal disorder, the incidence was similar in both groups GI - 35.3% and GII--33.3%. Nineteen patients (52.8%) in GI and 23 (67.6%) in GII had their complaints clarified through the videofluoroscopy. CONCLUSIONS: Under the conditions of this study, it can be concluded that: 1. The clinical complaints associated with the difficulty of deglutition occur at a similar frequency in adults and older people, with the exception of heartburn that occurs in larger number among adults; 2. Older people present a higher incidence of oropharyngeal deglutition problems; 3. The videofluoroscopy of the deglutition represents a method of great importance for the diagnosis, because it allows the identification of morphofunctional disorders that cannot be adequately identified by anamnesis; 4. The capacity of clarifying diagnosis of the videofluoroscopy of the deglutition is higher in the older people group.

Avaliação clínica e videofluoroscópica de pacientes com distúrbios da deglutição - estudo comparativo em dois grupos etários: adultos e idosos / Clinical and radiological study of swallowing in patients with deglutition disorders, classified into two age groups: adults and older people / Clinical and radiological study of swallowing in patients with deglutition disorders, classified into two age groups: adults and older people

RACIONAL: As anomalias do processo da deglutição têm etiologia multifatorial e complexa. A videofluoroscopia da deglutição tem sido apontada como o exame de maior utilidade na investigação diagnóstica desses casos. Tal método, quando precedido de anamnese clínica adequada, consegue caracterizar convenientemente o grau de disfunção e, freqüentemente, identificar a causa da anomalia com grande precisão. OBJETIVOS: Estudar as queixas clínicas e os achados da videofluoroscopia em pacientes com distúrbios da deglutição, sem evidências clínicas de afecções neurológicas associadas, distribuídos em duas faixas etárias - adultos e idosos - e analisar as manifestações sintomáticas, o tipo de disfunção (orofaríngea ou esofágica) e a capacidade de elucidação da queixa clínica pelo método de imagem. MATERIAL E MÉTODOS: Foram analisados 70 pacientes com queixa de alteração na capacidade de deglutição, sem evidências clínicas de afecções neurológicas associadas, distribuídos em dois grupos: adultos (GI) - idade inferior ou igual a 65 anos (n = 36) e idosos (GII) - idade superior a 65 anos (n = 34). Todos foram submetidos a anamnese para obtenção de informações sobre queixas em relação à deglutição; as queixas foram caracterizadas como altas ou baixas, de acordo com o local predominante de manifestação. Todos os pacientes foram submetidos a videofluoroscopia da deglutição; as alterações observadas com esse exame foram caracterizadas como orofaríngeas ou esofágicas. Avaliou-se a capacidade de elucidação da queixa clínica pela videofluoroscopia nos dois grupos. RESULTADOS: Dentre as queixas analisadas, a única cuja análise estatística demonstrou diferença significante entre os grupos, foi a de pirose, que ocorreu com maior freqüência no grupo de adultos (oito pacientes (22,2 por cento) do GI e um (2,9 por cento) do GII referiam tal queixa). Ao estudo videofluoroscópico, observou-se maior ocorrência de disfunção orofaríngea no grupo de pacientes idosos (41,2 por cento GII x 13,9 por cento GI)...

BACKGROUND: The abnormalities of swallowing process have multifactor and complex etiologies. The videofluoroscopy has been pointed as the exam of greater utility in diagnostic investigation for these cases. This method, when preceded of an adequate anamnesis, can characterize conveniently the level of the dysfunction and usually identify the cause of abnormality with great precision. AIMS: To study the clinical complaints and findings of the videofluoroscopy examination in patients with deglutition disorders and no clinical evidence associated with neurological disorder, classified into two age groups: adults and older people, and to analyze: symptomatic manifestations, kinds of disorders (oropharyngeal or esophageal) and the capacity of clarifying the clinical complaints through the method of images. MATERIALS AND METHODS: Seventy patients with complaint of the capacity of deglutition were analyzed. They had no clinical evidence of associated neurological syndromes or disorders and were classified into two age groups: adults (GI) - £65 years (n = 36) and older (GII) >65 years (n = 34). All patients were submitted to anamnesis to obtain the information about their complaints concerning deglutition. The complaints were characterized as high or low, according to their predominant location of manifestation. All the patients were submitted to videofluoroscopy of the deglutition; these alterations were characterized as oropharyngeal or esophageal. The capacity of clarifying the clinical complaints by videofluoroscopy was evaluated in both groups. RESULTS: Among the complaints analyzed, the only one in which the statistical analysis presented a significant difference between the groups was the complaint of heartburn, which occurred more often in the group GI - eight patients (22.2 percent) and GII - one patient (2.9 percent). In the study of videofluoroscopy, it was observed a higher incidence in the oropharyngeal disorder in group GII - 41.2 percent while in...